| NPI | 1942518147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT 26779) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NC 12739) |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2013-08-28 |